Predictors of intensive care unit length of stay and mortality among unvaccinated COVID-19 patients in Jordan

Infect Prev Pract. 2023 Jun;5(2):100278. doi: 10.1016/j.infpip.2023.100278. Epub 2023 Mar 20.

Abstract

Background: Factors associated with mortality and intensive care unit (ICU) admission due to Coronavirus Disease 2019 (COVID-19) in Jordanian patients are not known particularly among unvaccinated patients.

Aim: To examine predictors of mortality and ICU stay in unvaccinated COVID-19 patients in the north of Jordan.

Methods: Patients admitted with COVID-19 between October-December 2020 were included. Data on baseline clinical and biochemical characteristics, length of ICU stay, COVID-19 complications and mortality were collected retrospectively.

Findings: 567 COVID-19 patients were included. The mean age was 64.64±0.59 years. 59.9% of patients were males. The mortality rate was 32.3%. Underlying cardiovascular disease or diabetes mellitus was not associated with mortality. The mortality increased with the number of underlying diseases. Independent predictors of ICU stay were neutrophil/lymphocyte ratio, invasive ventilation, the development of failure, myocardial infarction, stroke and venous thromboembolism. The use of multivitamins was observed to be negatively associated with ICU stay. Independent predictors of mortality were age, underlying cancer, severe COVID-19, neutrophil/lymphocyte ratio, C-reactive protein (CRP), creatinine level, pre-use of antibiotics, ventilation during hospitalisation, and length of ICU stay.

Conclusion: COVID-19 was associated with an increased length of ICU stay and mortality among unvaccinated COVID-19 patients. The prior use of antibiotics was also associated with mortality. The study highlights the need for close monitoring of respiratory and vital signs, inflammatory biomarkers such as WBC and CRP, and prompt ICU care in COVID-19 patients.

Keywords: COVID-19; ICU stay; Jordan; Mortality; Ventilation.